Assessment of risk for pulmonary tuberculosis after non-reactive tuberculin skin testing among patients with HIV infection in a resource-limited setting

Int J STD AIDS. 2008 Dec;19(12):843-7. doi: 10.1258/ijsa.2008.008123.

Abstract

A cross-sectional study of 350 patients with HIV-1 infection was conducted to identify risks for pulmonary Mycobacterium tuberculosis (TB) after non-reactive two-step tuberculin skin tests (TST). Among 219 patients (62.6%) with non-reactive TST, independent risks for active pulmonary TB were prior known TB exposure (adjusted odds ratio [aOR] = 16.00, 95% confidence interval [CI] = 2.00-26.36, P = 0.008), CD4 <100 cells/microL (aOR = 2.50, 95% CI = 1.30-6.50, P = 0.04) and less than secondary-school education (aOR = 2.60, 95% CI = 1.50-6.90, P = 0.02). Our findings suggest that further diagnostic work-up for pulmonary TB is warranted among patients with HIV infection, non-reactive TSTs and either prior known TB exposure, CD4 counts <100 cells/microL or limited formal education.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • HIV Infections / complications*
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis
  • Poverty
  • Risk Assessment
  • Risk Factors
  • Tuberculin Test*
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / microbiology
  • Young Adult